Medicare Compliance & Reimbursement

Contact docs now to let them in on a new way to make money.

It's final: Physician practices can bill for care plan oversight (CPO) provided by non-physician practitioners (NPPs). And that means it's time for HHAs to fire up their marketing machines.

Out with the old: The Centers for Medicare & Medicaid Services has eliminated the provision limiting CPO billing to the physician who certified or recertified the plan of care for the home care patient. In with the new: That means NPPs now can bill for the service. Physician assistants can perform the service, but cannot independently bill for it, CMS notes in the final physician fee schedule set to premiere in the Nov. 15 Federal Register.

Back in 2000 CMS opened up CPO billing to NPPs, but the certification requirement had kept NPPs from being able to bill, a CMS official explained in the Nov. 9 Open Door Forum for home care providers. Expert: HHAs Should Say 'Hooray!' For Change This is a positive development for home health agencies and physicians, says Claudia Reingruber of Reingruber & Co. in St. Petersburg, FL.

More physician practices are likely to bill for CPO under the relaxed rules, predicts clinical consultant Judy Adams with LarsonAllen Health Care Group in Charlotte, NC. Nurses may be more willing and able than docs to keep exact records of the time they spend on CPO services, thus facilitating billing, Reingruber notes.

The change promotes better physician service to home care patients and could encourage physicians to refer patients to home care more often. Let Docs Know How Change Helps Them HHAs can increase their benefit by using the new information in their marketing programs, advises Mike Ferris of Home Care Marketing Solutions in Chapel Hill, NC. Agencies can get valuable face time with physicians and their staff, gain trust and win referrals by passing along the information.

If agencies advised docs of the change when it was proposed in August, now is the time to follow up with the final information, Ferris advises.

"The goal is to be the trusted resource for Medicare home care information," he reminds HHAs.

Good advice: If providers haven't yet contacted physicians on this topic, "there is no time like the present," Ferris urges.